Organization
SONRISA DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANY SICALO (ADMINISTRATOR)
(480) 751-7708
Entity
Organization
Contact information
Practice address
1701 W GLENDALE AVE, SUITE 1, PHOENIX, AZ 85021-9701
(602) 466-1213
(602) 466-3874
Mailing address
9216 N CENTRAL AVE, PHOENIX, AZ 85020-2416
(602) 466-1213
(602) 466-3874
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/12/2013
Last updated
04/12/2013
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